POS0524 THE VALUE OF ULTRASOUND AND MAGNETIC RESONANCE IMAGING SCORING TECHNIQUES FOR DETECTING JOINT INFLAMMATION AND DAMAGE IN RHEUMATOID ARTHRITIS PATIENTS IN EXPLAINING FUNCTIONAL IMPAIRMENT AND HANDGRIP STRENGTH: A PILOT STUDY
Authors: F. Salaffi, M. Carotti, M. DI Carlo, L. Ceccarelli, S. Farah, A. Giovagnoni
Journal: Annals of the Rheumatic Diseases (2022)

Background Composite disease activity ratings, which are used to assess the severity of rheumatoid arthritis (RA), may not effectively reflect the illness’s spatial impact on the hands. In RA, assessments of handgrip strength (HGs) and functional deficits are a kind of objective examination that focuses on the hands. Objectives The goal of this study was to see if there was a link between joint inflammation and damage in the wrists and hands, as measured by ultrasound (US) and magnetic resonance imaging (MRI), functional disability as measured by hand-specific self-report questionnaires, and composite disease activity indices. Methods Sixty-six female patients with RA were investigated (age 55.6 ± 12.2 years, range 20-80 years; disease duration 4.4 ± 3.0 years). The DAS28-CRP, the SDAI, the CDAI, and US and MRI scoring techniques such as the UltraSound-CLinical ARthritis Activity (US-CLARA) and modified Simplified Rheumatoid Arthritis Magnetic Resonance Imaging Score [SAMIS] were all used as baseline assessments (mod SAMIS) (Figure 1). Without contrast injection, the mod SAMIS score was rated for the presence/absence and semiquantitative assessments of synovitis, bone erosion (ERO), and bone marrow edema (BME). All patients had HGs and completed the shortened Disability of Arm, Shoulder, and Hand Questionnaire (QuickDASH), the Arthritis Impact Measurement Scales hand and finger function subscale, and the upper extremity function sub-score of the ROAD. Figure 1. The modified simplified SAMIS magnetic resonance score (mod SAMIS) scoring spreadsheet. The MRI was graded for the presence/absence of synovitis and semiquantitative ratings of bone marrow oedema and bone erosion, without contrast injection. Results The mod SAMIS total score and the US-CLARA had a strong correlation (rho=0.377, p=0.0018) for all patients. Among the SAMIS sub-scores, there was a significant relationship between mod SAMIS bone oedema (SAMIS-BME) and US-CLARA (rho=0.799, p&lt;0.001) and mod SAMIS synovitis (SAMIS-synovitis) and US-CLARA (rho=0.539, p&lt;0.001). There were also significant negative relationships between the HGs score and the mod SAMIS total score and US-CLARA (rho = -0.309, p=0.011 and rho = -0.775, p&lt;0.0001, respectively). The HGs and disease activity composite indices, as well as hand-specific self-report questionnaires, were shown to have high relationships (p&lt;0.0001) in individuals with RA. The hand and finger function sub-scales, as well as the mod SAMIS erosion (SAMIS-ERO) and HGs, exhibited no significant relationship. For each of the three components, interobserver agreement was good to excellent (intraclass correlation values = 0.713, 0.912, and 0.821, respectively) (synovitis, BME, and BME) (Figure 2). Figure 2. Scatterplot with linear regression lines displays the relationship between (A) mod SAMIS total score vs HGs, (B) US-CLARA vs HGs, and (C) US-CLARA vs mod SAMIS total score. Conclusion BME and synovitis have an impact on upper-extremity function. The US-CLARA and mod SAMIS total score are promising solutions for semi-quantitative evaluation of joint inflammation and damage in RA. These shortened scores might cut down on image processing time in US and MRI-controlled RA investigations, as well as make using these imaging modalities in RA treatment response evaluation studies simpler. References [1]Salaffi F, Carotti M, Farah S, Ceccarelli L, Di Carlo M. Handgrip Strength Features in Rheumatoid Arthritis Patients Assessed Using an Innovative Cylindrical-Shaped Device: Relationships With Demographic, Anthropometric and Clinical Variables. J Med Syst. 2021, 9;45(11):100. [2]Salaffi F, Di Carlo M, Iannone F, Fedele AL, Epis OM, Pellerito R, Foti R, Passiu G, Punzi L, Furini F, Sarzi-Puttini P, Carletto A, Gremese E, Lapadula G, Ferraccioli G. The UltraSound-CLinical ARthritis Activity (US-CLARA) index: Properties of a new composite disease activity index for rheumatoid arthritis. Semin Arthritis Rheum. 2018;47(5):619-629. Disclosure of Interests None declared.